Jamie Posted Tue 16th of July, 2019 12:03:29 PM
CPT 10120 states "Incision and removal of foreign body" which is one foreign body. If the provider removed 3 splinters this code gets billed out 3 times? Does it matter if it would be the same location or wound? Providers documentation state - "SKIN- There are 3 shallow slivers in the right hand.Splinters removed with an 11 blade scalpel without complication." Please advise Thank you
SuperCoder Answered Wed 17th of July, 2019 05:17:27 AM
In CPT 10120 (Incision and removal of foreign body, subcutaneous tissues; simple), the provider uses appropriate instrumentation to remove the foreign body. As this is a simple incision, it is not complicated; therefore, this type of foreign body removal requires no dissection. The provider incises the skin around the foreign body to better expose it and then removes it with forceps. The provider closes the incision and cleans and dresses the wound.
In your procedure, there are 3 shallow splinters have been removed from right hand, payers may balk at paying multiple foreign body removals. You may, therefore, need to use a modifier, such as 51 (Multiple procedures), on the subsequent removal codes. For example, report 10120, 10120-51 x 2 for the removal of three splinters from the hand. Using modifier 51 typically reduces subsequent procedure payments by 50 percent. Also, append modifier RT with the procedure code.
If this is performed on the different anatomical sites, then add the units and bill. Make a note that, maximum reporting units are three for CPT 10120.
Refer the following article for the further details:
Please let us know in case you are not able to access the article, so that we can provide you the same.
Hope this helps!